I would like to get back into utilization review or become a case manager. Where should I start?

By | 2022-02-23T14:29:43-05:00 December 13th, 2012|0 Comments


Dear Donna,

I am an RN with more than 20 years experience. However, I worked in a hospital setting for only a year — then I worked for more than eight years in two physicians’ offices, where I did back office duties. This included inserting IVs, drawing blood and assisting with surgeries. I am certified in infection control and worked for an insurance company doing utilization review for two years, which I would like to get back into. I also am interested in becoming a case manager. I am unemployed right now and really need to get back to work. Which classes or schools do you recommend? Would I qualify to become certified with my background? Where should I start?


Dear Donna replies:

Dear Unemployed,

You don’t need to be certified to get back into utilization review or case management, so don’t even concern yourself with that. Your past experience will serve you well.

Make direct contact with any insurance companies in your area. Find them online and call the human resources department. Some insurance companies have nurse recruiters on staff. Try to connect with anyone you previously worked with or for in the insurance industry. If not currently in contact with them, try to find them on Facebook or LinkedIn. Let them know what you are looking for and ask for introductions, referrals, recommendations and leads. Networking is known to be a very effective way to find a job.

Attend local chapter meetings of the Case Management Society of America (www.cmsa.org) or utilization review association, as a guest for now. Mix and mingle and make contacts. Do informational interviewing (www.Nurse.com/Cardillo/Interviewing) with members and officers. When there’s something you want to do it makes sense to rub elbows with those already doing it. Face-to-face networking is the most effective type. Have business cards made for exchanging professional contact information and buy or borrow a business suit. First impressions really matter.

Since you’re currently unemployed, start volunteering in a healthcare setting while you look for paid employment. Consider your local public health department, the American Heart Association, American Red Cross or a free clinic. This gives you recent experience to put on your resume, will expand your network and helps to build confidence and work stamina. Volunteer work often leads to paid employment.

Start creating positive momentum in all of the above ways and the right opportunity will eventually come your way. Be sure your resume, interviewing, networking, and self-marketing skills are up to date. Read “The ULTIMATE Career Guide for Nurses: Practical advice for thriving at every stage of your career” (www.nurse.com/ce/7250).

Best wishes,


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